Fast and Interpretable Mortality Risk Scores for Critical Care Patients

Prediction of mortality in intensive care unit (ICU) patients is an important task in critical care medicine. Prior work in creating mortality risk models falls into two major categories: domain-expert-created scoring systems, and black box machine learning (ML) models. Both of these have disadvantages: black box models are unacceptable for use in hospitals, whereas manual creation of models (including hand-tuning of logistic regression parameters) relies on humans to perform high-dimensional constrained optimization, which leads to a loss in performance. In this work, we bridge the gap between accurate black box models and hand-tuned interpretable models. We build on modern interpretable ML techniques to design accurate and interpretable mortality risk scores. We leverage the largest existing public ICU monitoring datasets, namely the MIMIC III and eICU datasets. By evaluating risk across medical centers, we are able to study generalization across domains. In order to customize our risk score models, we develop a new algorithm, GroupFasterRisk, which has several important benefits: (1) it uses hard sparsity constraint, allowing users to directly control the number of features; (2) it incorporates group sparsity to allow more cohesive models; (3) it allows for monotonicity correction on models for including domain knowledge; (4) it produces many equally-good models at once, which allows domain experts to choose among them. GroupFasterRisk creates its risk scores within hours, even on the large datasets we study here. GroupFasterRisk's risk scores perform better than risk scores currently used in hospitals, and have similar prediction performance to black box ML models (despite being much sparser). Because GroupFasterRisk produces a variety of risk scores and handles constraints, it allows design flexibility, which is the key enabler of practical and trustworthy model creation.